Moving to smaller commissioning units flies in face of international evidence on effectiveness

BMJ 2010; 341 doi: (Published 28 October 2010) Cite this as: BMJ 2010;341:c6087
  1. Oona Mashta
  1. 1London

The coalition government’s proposed shift of commissioning from primary care trusts to GP consortiums may harm patient care as it flies in the face of international evidence showing that bigger commissioning bodies are more effective, says a report by an independent think tank.

The government intends to replace 152 trusts with much smaller commissioning organisations even though there is no evidence that they are better at commissioning than larger ones, says the report by Civitas in conjunction with the Manchester Business School.

The report, GP Commissioning: Does Size Matter?, also argues that the transition will be costly, almost certainly resulting in a dip in performance …

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